Complementary and Alternative Medicine Teaching: Evaluation of theTeaching-Learning Process of Integrative Practices in Brazilian Medical Schools

Leila Verônica Da Costa Albuquerque,José Wellington De Oliveira Lima,Matheus Costa Bessa,Ludmila Rios Osterno Gomes Maia,Ana Beatriz Gois Da Silva,Ingrid Cavalcante Morais Correia,Olívia Andrea Alencar Costa Bessa

doi:10.1590/1981-52712015v43n4rb20180259ingles

Leila Verônica Da Costa Albuquerque, José Wellington De Oliveira Lima + Show 5 more

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https://doi.org/10.1590/1981-52712015v43n4rb20180259ingles

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Abstract

ABSTRACT Context Complementary and Alternative Medicine (CAM) are unconventional care practices that, according to the World Health Organization, should be implemented in the Health System, particularly in poor regions of the country. In Brazil, they have been adopted by Care Programs and introduced into undergraduate medical education. In this study we were interested in evaluating the teaching-learning process of Integrative Practices in Brazilian medical schools. Methodology A cross-sectional study was carried out at Brazilian medical schools with a self-administered questionnaire for teachers and a secondary data survey was obtained from medical school websites and government database institutions. For the presentation of the variables, frequency distribution and the Pearson coefficient (X2) -Chi-square tests were used. The proportions were compared using the Chi-square test or the Fisher’s Exact Test. When the expected value of a contingency table was equal to or greater than 5, the Chi-square test was used; in all other situations, Fisher’s Exact Test was used. The difference between proportions was estimated by the Odds Ratio, calculated through simple logistic regression (95% CI). Results 57 of the 272 medical schools in Brazil address CAM, with it being proportionally higher in the South and Mid-West regions. The medical schools are highly concentrated in state capitals, and the Northeast region presents a significant concentration of medical schools with CAM in the capitals. The number of schools with active and traditional methodologies in CAM is equivalent. Homeopathy, Acupuncture and Integrative Medicine predominate, with a minority using Indigenous Practices, Chronotherapy and Anthroposophic Medicine. The new educational guidelines have not affected the number of schools with CAM. Growth in CAM has been insignificant (p <0.05) in the last ten years. Conclusion There has been no growth in teaching Complementary and Alternative Medicine in undergraduate medical training in Brazil since the introduction of the new curricular guidelines, even in view of the needs of the health system.

Highlights

Complementary and Alternative Medicine (CAM) is a set of interventions and unconventional approaches used in health care, which relies on individual integrality, taking into consideration the global dimension without losing sight of the individual’s singularity, to help explain their processes of illness and health, it is known as holistic or systemic medicine [1; 2; 3]
There is an even distribution of medical schools, considering the percentage of population by region, but when considering the ratio of the number of available places per inhabitant per region, the total university courses in the Southeast region is the largest in relation to the rest of the country, while the North and Northeast regions have the lowest ratio of available places per inhabitant (Table 1)
The conclusion can be drawn that the number of medical schools almost tripled after 1970, but there was no increase in CAM teaching in these schools, there was a reduction in their implementation in the national scenario

Summary

Introduction

Complementary and Alternative Medicine (CAM) is a set of interventions and unconventional approaches used in health care, which relies on individual integrality, taking into consideration the global dimension without losing sight of the individual’s singularity, to help explain their processes of illness and health, it is known as holistic or systemic medicine [1; 2; 3]. The demand for unconventional therapies in treatment of various diseases and health problems has been increasing in recent decades and such treatment have been applied in a complementary or integrated manner in relation to the traditional biomedical model These practices have been introduced into the health system through their incorporation into care programs in several Western nations [4; 5]. The program advocates incorporation of practices such as Phytotherapy, Acupuncture, Thermalism, and Anthroposophic Medicine in the SUS [1; 11; 12] This process, which began with the WHO recommendation, emphasized the importance of integrating traditional non-biomedical practices and so-called “alternatives” toward a reformulated and expanded national health service [1; 7]

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